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Paget's Disease of Bone


Topic Overview

Picture of the skeletonWhat is Paget's disease?

Paget's disease is a long-lasting (chronic) condition that causes abnormal bone growth. Bone is constantly being replaced as bone tissue is broken down and absorbed into the body, then rebuilt with new cells. In the early stages of Paget's disease, bone tissue is broken down and absorbed much faster than normal. To keep up with the rapid breakdown of bone tissue, the body speeds up the bone rebuilding process. But this new bone is often weak and brittle, causing it to break (fracture) more easily.

Paget's disease usually affects the bones in the pelvisClick here to see an illustration., spineClick here to see an illustration., thigh (femurClick here to see an illustration.), skull, shin (tibia), and upper arm (humerusClick here to see an illustration.). One bone or several bones may be affected by Paget's disease.

What causes Paget's disease?

The cause of Paget's disease is not clear. Genetic factors and viruses may play a role in the development of the disease.

What are the symptoms?

Most people with Paget's disease have no symptoms. When symptoms are present, the most common are bone pain, deformed bones (bowed legs, enlarged skull or hips, or a curved backbone), and fractures. Because the bone pain may be aching and hard to describe, you may think it is part of the aging process.

Other symptoms may occur as the result of the location of Paget's disease. For example, the disease can affect the skull and cause headaches, dizziness, loss of muscle strength in the face (facial droop), or problems with vision or hearing. When the disease affects the spine, nerves can become damaged and cause leg pain, numbness, weakness, or cauda equina syndrome (an emergency condition with symptoms that include loss of feeling in the pelvic area and legs).

How is Paget's disease diagnosed?

Most often, Paget's disease is discovered when you see a doctor or nurse for a different reason, such as hip or back pain. A bone X-ray or a blood test with above-normal levels of the enzyme alkaline phosphatase often leads to the discovery of the disease. Doctors usually diagnose Paget's disease based on your medical history, a physical exam, bone X-rays, lab tests, and possibly a bone scan.

How is it treated?

Paget's disease is treated with medicines that slow the rapid breakdown of bone tissue. You might also take medicines to relieve pain. You may need treatment to try to prevent complications such as osteoarthritis even if you do not yet have symptoms of Paget's disease. Later in the disease process, you may need surgery to replace a hip or knee joint damaged by the disease.

Learning about Paget's disease:

Being diagnosed:

Getting treatment:

Living with Paget's disease:

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